Does Family Planning Reduce Infant Mortality? Evidence from Surveillance Data in Matlab, Bangladesh

Abstract: Analyzing the effect of family planning on child survival remains an important issue but is not straightforward because of several mechanisms linking family planning, birth intervals, total fertility, and child survival. This study uses a dynamic model jointly explaining infant mortality, whether contraceptives are used after each birth, and birth intervals. Infant mortality is determined by the preceding birth interval and other covariates (such as socio-economic status). The decisions about using contraceptives after each birth are driven by similar covariates, survival status of the previous child, and the family’s gender composition. Birth spacing is driven by contraceptive use and other factors. We find favourable effects of contraceptive use, reducing infant deaths in second and higher order births. Because the mortality risks for first-borns is higher than for later births and contraceptive use reduces the number of higher order births, the net effect on the total infant mortality rate is small.